Dr. Phillips received his bachelor's degree in Psychology from Stanford University. After graduating from medical school at the University of Southern California, he completed his residency training and served as Chief Pediatric Resident at UCLA- Harbor General Hospital in Los Angeles.
Dr. Mersch received his Bachelor of Arts degree from the University of California, San Diego, and prior to entering the University Of Southern California School Of Medicine, was a graduate student (attaining PhD candidate status) in Experimental Pathology at USC. He attended internship and residency at Children's Hospital Los Angeles.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
What medications are currently being used to treat ADHD?
Psychostimulant medications, including methylphenidate (Ritalin, Metadate,
and Concerta), amphetamine (Dexedrine, Vyvanse, and Adderall),
and atomoxetine (Strattera, marketed as a "non-stimulant," although its mechanism of action and potential side effects are essentially equivalent to the "psychostimulant" medications), a newer drug, are by far the most widely researched and commonly prescribed treatments for ADHD. Numerous short-term studies have established the safety and effectiveness of stimulants and psychosocial (behavioral therapy) treatments for not only alleviating the symptoms of ADHD but also improving the child's ability to follow rules and improve relationships with peers and parents. National Institute of Mental Health (NIMH) research has indicated that the two most effective treatment modalities for elementary-school children with ADHD are a closely monitored medication treatment or a program that combines medication with intensive behavioral interventions (behavior therapy). In the NIMH Multimodal Treatment Study for Children with ADHD (MTA), which included nearly 600 elementary-school children across multiple sites, nine out of
10 children improved substantially on one of these treatment programs.
Two types of antidepressant medications, the "tricyclic antidepressants" (TCA) (imipramine,
desipramine, and nortriptyline) and
bupropion (Wellbutrin), have also been shown to have a positive effect
on all three of the major components of ADHD: inattention, impulsivity, and hyperactivity. They tend, though, to be considered as second options for the children who have shown inadequate response to stimulant medication or who experience unacceptable side effects from stimulant medication such as tics (uncontrolled movement disorders) or insomnia. The antidepressants, however, have a greater potential for side effects of their own, such as heart-rate and rhythm changes, dry mouth, headaches, and drowsiness, to name a few.
If higher doses are required, bupropion may bring on seizures. The antidepressants, therefore, require more careful monitoring.
For the child who has a combination of ADHD and comorbid conditions such as depression, anxiety disorders, or mood disorders, stimulant medications can be combined with an antidepressant medication very successfully.
What is attention deficit hyperactivity disorder (ADHD)?
ADHD refers to a chronic biobehavioral disorder that initially manifests in childhood and
is characterized by hyperactivity, impulsivity, and/or inattention. Not all of
those affected by ADHD manifest all three behavioral categories. These symptoms
can lead to difficulty in academic, emotional, and social functioning. The
diagnosis is established by satisfying specific criteria and may be associated
with other neurological, significant behavioral, and/or developmental/learning
disabilities. Therapy may consider the use of medication, behavioral therapy, and
adjustments in day-to-day lifestyle activities.
Studies in the United States indicates approximately 8%-10% of
children satisfy diagnostic criteria for ADHD. ADHD is, therefore, one of the
most common disorders of childhood. ADHD occurs two to four times more commonly
in boys than girls (male to female ratio 4:1 for the predominantly hyperactive
type vs. 2:1 for the predominantly inattentive type). Three subtypes of ADHD are described: (1) predominantly inattentive, (2) predominantly hyperactive and impulsive, and (3) combined. While previously believed to be "outgrown" by adulthood, current opinion indicates that many children will continue throughout life with symptoms that may affect both occupational and social functioning. Some medical researchers note that approximately 40%-50% of ADHD-hyperactive children will have (typically non-hyperactive) symptoms persist into adulthood.
What is the cause of ADHD?
The cause of ADHD has not been fully defined. One theory springs from observations in functional brain imagining studies between those with and without symptoms. However, other authorities point out that similar variations have been shown in studies of the structure of the brain of affected and non-affected individuals. Animal studies have demonstrated differences in the chemistry of brain transmitters involved with judgment, impulse control, alertness, planning, and mental flexibility.
A genetic predisposition has been demonstrated in (identical) twin and sibling studies. If one identical twin is diagnosed with ADHD, there is at 92% probability of diagnosis with the twin sibling. When comparing nonidentical twin sibling subjects, the probability falls to 33%. (Overall population incidence is 8%-10% in the U.S., as described above.)
What are ADHD symptoms and signs?
The diagnostic criteria for ADHD are outlined in the Diagnostic and Statistical Manual of Mental Health,
4th ed. (DSM-IV). All of the symptoms of inattention, hyperactivity, and impulsivity must have persisted for at least
six months to a degree that is maladaptive and inconsistent with the developmental level of the child.
Inattention:
The child often fails to give close attention to details or makes careless mistakes in schoolwork, work, or other activities.
The child often has difficulty sustaining attention in tasks or play activities.
The child often does not seem to listen when spoken to directly.
The child often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (not due to oppositional behavior or failure to understand instructions).
The child often has difficulty organizing tasks and activities.
The child often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (such as schoolwork or homework).
The child often loses things necessary for tasks or activities (toys, school assignments, pencils, books, or tools).
The child is often easily distracted by extraneous stimuli.
The child is often forgetful in daily activities.
Hyperactivity:
The child often fidgets with his/her hands or feet or squirms in his/her seat
.
The child often leaves his/her seat in the classroom or in other situations in which remaining seated is expected.
The child often runs about or climbs excessively in situations in which it is inappropriate.
The child often has difficulty playing or engaging in leisure activities quietly
.
The child often talks excessively.
Impulsivity:
The child often blurts out answers before questions have been completed.
The child often has difficulty awaiting his/her turn
.
The child often interrupts or intrudes on others (for example, butts into conversations or games).
DSM-IV criteria for diagnosis of ADHD requires that some hyperactive, impulsive, or inattention symptoms that cause present difficulties were present before 7 years of age and are present in two or more settings (at school [or work] or at home). Similarly, there must be clear evidence of significant impairment in social, academic, or occupational functioning. In addition, symptoms may not entirely be caused by another severe physical disorder (for example, severe illness associated with chronic pain) or mental disorder (for
example, schizophrenia, other psychotic disorders, severe disabling mood disorders, etc.).
Inattention symptoms are most likely to manifest about at 8 to 9 years of age and
commonly are lifelong. The "delay" in onset of inattentive symptoms may reflect
its more subtle nature (vs. hyperactivity) and/or variability in the maturation
of cognitive development. Hyperactivity symptoms are usually obvious by 5 years
of age and peak in severity between 7 to 8 years of age. With maturation, these
behaviors progressively decline and often have been "outgrown" by adolescence.
Impulsive behaviors are commonly linked to hyperactivity and also peak about 7
to 8 years of age; however, unlike their hyperactive counterpart, impulsivity
issues remain well into adulthood. Impulsive adolescents are more likely to
experiment with high-risk behaviors (drugs, sexual
activity, driving, etc.). Impulsive
adults have a higher rate of financial mismanagement (impulse buying, gambling,
etc.).
Anxiety is a feeling of apprehension and fear characterized by physical symptoms. Anxiety disorders are serious medical illnesses that affect approximately 19 million American adults.
Stress occurs when forces from the outside world impinge on the individual. Stress is a normal part of life. However, over-stress, can be harmful. There is now speculation, as well as some evidence, that points to the abnormal stress responses as being involved in causing various diseases or conditions.
Depression is an illness that involves the body, mood, and thoughts and affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things. The principal types of depression are major depression, dysthymia, and bipolar disease (also called manic-depressive disease).
Suicide is the process of intentionally ending one's own life. Approximately 1 million people worldwide commit suicide each year, and 10 million to 20 million attempt suicide annually.
Bipolar disorder (or manic depression) is a mental illness characterized by depression, mania, and severe mood swings. Treatment may incorporate mood stabilizer medications, antidepressants, and psychotherapy.
Antisocial personality disorder (ASPD) has many symptoms, signs, and causes. Therapy is one treatment option for antisocial personality disorder. It is closely related to other personality disorders (PD), such as borderline personality disorder and narcissistic personality disorder.
Smoking is an addiction. More than 430,000 deaths occur each year in the U.S. from smoking related illnesses. Secondhand smoke or "passive smoke" also harm family members, coworkers, and others around smokers. There are a number of techniques available to assist people who want to quit smoking.
ADHD afflicts approximately 3 percent to 5 percent of school-age children and an estimated 60 percent of those maintain the disorder into adulthood. Symptoms of adult ADHD include chronic lateness, anxiety, low self esteem, employment problems, difficulty controlling anger, impulsiveness, poor organization skills, procrastination, chronic boredom among others.
Alcohol is the most frequently used drug by American teenagers. Teens that drink are more likely to drive under the influence, have unprotected sex, and use other drugs, like marijuana, cocaine, and heroin. Symptoms of alcohol abuse in teens include lying, breaking curfew, becoming verbally or physically abusive toward others, making excuses, smelling like alcohol, having mood swings, and stealing.
Learning disabilities can cause an individual to have trouble learning and using skills such as reading, listening, writing, reading, speaking, reasoning, and performing mathematics. There is no cure for learning disabilities. Parents and teachers working together to properly diagnose learning disabilities can properly plan a course of education. For some, medication may be appropriate as complimentary treatment.
Drugs commonly abused by teens include tobacco products, marijuana, cold medications, inhalants, depressants, stimulants, narcotics, hallucinogens, PCP, ketamine, Ecstasy, and anabolic steroids. Some of the symptoms and warning signs of teen drug abuse include reddened whites of eyes, paranoia, sleepiness, excessive happiness, seizures, memory loss, increased appetite, discolored fingertips, lips or teeth, and irritability. Treatment of drug addiction may involve a combination of medication, individual, and familial interventions.
Childhood depression can interfere with social activities, interests, schoolwork and family life. Symptoms and signs include anger, social withdrawal, vocal outbursts, fatigue, physical complaints, and thoughts of suicide. Treatment may involve psychotherapy and medication.
Mental illness is any disease or condition affecting the brain that influence the way a person thinks, feels, behaves, and/or relates to others. Mental illness is caused by heredity, biology, psychological trauma and environmental stressors.
Compulsive gambling is a disorder that affects millions in the U.S. Symptoms and signs include a preoccupation with gambling, lying to family or loved ones to hide gambling, committing crimes to finance gambling, and risking importance relationships and employment due to gambling. Treatment may incorporate participation in Gamblers' Anonymous, psychotherapy, and medications like carbamazepine, topiramate, lithium, naltrexone, antidepressants, clomipramine, and fluvoxamine.
About 5 million children and adolescents in the U.S. suffer from a serious mental illness such as eating disorders, anxiety disorders, disruptive behavior disorders, pervasive development disorders, elimination disorders, learning disorders, schizophrenia, tic disorders, and mood disorders. Symptoms of mental illness include frequent outbursts of anger, hyperactivity, fear of gaining weight, excessive worrying, frequent temper tantrums, and hearing voices that aren't there. Treatment may involve medication, psychotherapy, and creative therapies.
Asperger syndrome (AS, Asperger's syndrome) is an autism spectrum disorder. Asperger syndrome is characterized by a degree of impairment in language and communication skills, and repetitive or restrictive thoughts or behaviors. The most common symptom of Asperger syndrome is the obsessive interest in a single object or topic. Other conditions that may co-exist with Asperger syndrome include: ADHD, tic disorders, depression, anxiety disorders, and OCD. Diagnosis of Asperger syndrome is complicated, and treatment is generally directed toward minimizing the symptoms of the syndrome and behavioral and educational interventions.
Bipolar disorder, or manic-depressive illness, is a disorder that causes unusual and extreme mood changes. Symptoms of bipolar disorder in children and teens include having trouble concentrating, behaving in risky ways and losing interest in activities they once enjoyed. Treatment for bipolar disorder in children and teenagers incorporates psychotherapy and medications.
Children's health is focused on the well-being of children from conception through adolescence. There are many aspects of children's health, including growth and development, illnesses, injuries, behavior, mental illness, family health and community health.
Attention deficit hyperactivity disorder (ADHD) can be challenging for a parent or caregiver with a child with this disorder. There are steps, routines, and help for parents and caregivers of children with ADHD to help guide the family toward a productive and healthy life.
Teenagers recognize that they are developmentally between child and adult. Teen health prevention includes maintaining a healthy diet, exercising regularly, preventing injuries and screening annually for potential health conditions that could adversely affect teenage health.
Children's health, or pediatrics,
focuses on the well-being of children from conception through adolescence. It is
vitally concerned with all aspects of children's growth and development and with
the unique opportunity that each child has to achieve their full potential as a
healthy adult.
Children's health was once a part of adult medicine. It
emerged in the 19th and early 20th century as a medical specialty because of the
gradual awareness that the health problems of children are different from those
of grown-ups. It was also recognized that a child's response to illness,
medications, and the environment depends upon the age of the child.
There are many aspects to children's health. Any organization of these aspects of
child health is necessarily arbitrary. For example, the topics could be
presented in alphabetical order. However, it seems most logical to start at the
beginning -- with the factors that d...
Psychostimulant medications, including 
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